H1N1 flu vaccine priorities offered

CDC advisory panel lists groups it says should be first in line for doses

By Thomas H. Maugh II Los Angeles Times

Published 1:00 am, Thursday, July 30, 2009

Pregnant women, parents and caretakers of young children, all health-care workers, young people between the ages of 6 months and 24 years, and non-elderly adults with underlying medical conditions should be first in line to receive the pandemic H1N1 influenza vaccine when it becomes available, an advisory committee for the Centers for Disease Control and Prevention said Wednesday.

That totals about 159 million people out of a population of more than 300 million. The CDC expects about 120 million doses of the vaccine to be available by the end of October, obviously not enough to cover all the recommended groups. But historically, only 20 percent to 50 percent of those recommended to receive the seasonal flu vaccine — about 83 percent of the population or 280 million people — actually seek it out, so officials are confident there will be plenty of the so-called swine flu vaccine available for those who want it.

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But should supplies of the new vaccine be unexpectedly restricted, the committee recommended that a smaller group of about 41 million people receive priority for the vaccine because they are most likely to suffer adverse effects from infection or to spread the virus: pregnant women, household contacts of children under the age of 6, only health-care workers with direct exposure to infected patients or to the virus, children between 6 months and four years of age, and children ages 5 to 18 with underlying risk factors.

But the committee strongly urged that the elderly receive the seasonal flu vaccine because they are the most susceptible group to complications from more common strains of the flu. Everyone else who is eligible for the seasonal vaccine should also receive it, the committee said.

Clinical trials will determine whether the two vaccines can be safely given on the same visit, but experts believe they can. The seasonal vaccine will be available sooner, however, so that may not be an issue. For now, experts also believe that two doses of the swine flu vaccine will be required for maximum protection.

Pregnant women have four times the normal risk of being hospitalized from complications of the H1N1 virus, and they account for 6 percent of deaths from H1N1 complications, even though they represent only 1 percent of the population.

The obese also appear to be at increased risk of complications from swine flu, but it is unclear now exactly why. The obese were not included as a separate group with vaccine priority, but Schuchat said the recommendations for people with medical conditions probably covers most of them anyway.